Article

Journal of Neural Transmission

, Volume 114, Issue 10, pp 1333-1337

Detecting asymmetries in balance control with system identification: first experimental results from Parkinson patients

  • H. van der KooijAffiliated withDepartment of Biomechanical Engineering, University of Twente
  • , E. H. F. van AsseldonkAffiliated withDepartment of Biomechanical Engineering, University of Twente
  • , J. GeelenAffiliated withDepartment of Neurology, Medisch Spectrum Twente
  • , J. P. P. van VugtAffiliated withDepartment of Neurology, Medisch Spectrum Twente
  • , B. R. BloemAffiliated withDepartment of Neurology, Radboud University Nijmegen Medical Centre

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Summary.

Cognitive processes can influence balance in various ways, but not all changes in postural performance can easily be identified with the naked clinical eye. Various studies have shown that dynamic posturography is able to detect more subtle changes in balance control. For patients with Parkinson’s disease (which is typically an asymmetric disease), changes in the symmetry of balance control might provide a sensitive measure of cognitive influences on balance. Here, we describe a new posturography technique that combines dynamic platform perturbations with system identification techniques to detect such asymmetries in balance control of two patients with Parkinson’s disease. Results were compared to those of six healthy controls. Our pilot data show clear asymmetries in dynamic balance control, even though patients themselves were not aware of this and had no subjective problems with stability or standing. We also found asymmetries in weight bearing, but the asymmetries in dynamic balance contribution were larger. Finally, asymmetries in weight bearing and dynamic balance in patients were not tightly coupled as in healthy controls. Future studies could incorporate this approach when examining the influence of mental decline on postural regulation.

Keywords: Parkinson; balance control; asymmetries; system identification; dynamic posturography